Organization
TREE OF LIFE MENTAL HEALTH COUNSELING PLLC
Active
Organization
TREE OF LIFE MENTAL HEALTH COUNSELING PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRYSTIE IZZO LMHC (OWNER)
(646) 220-4406
Entity
Organization
Contact information
Practice address
2291 VICTORY BLVD, STATEN ISLAND, NY 10314-6625
(646) 220-4406
Mailing address
2291 VICTORY BLVD, STATEN ISLAND, NY 10314-6625
(646) 220-4406
Taxonomy
Speciality
Code
Description
License number
State
261QM0850X
Adult Mental Health Clinic/Center
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
007045
LICENSE
NY
Enumeration date
04/23/2019
Last updated
06/11/2019
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